BACKGROUND Given the controversy of selecting a diagnostic and treatment approach for the febrile child at risk for occult bacteremia, the purpose of this study is to survey the diagnostic and treatment strategies chosen by pediatricians for a febrile child at risk for occult bacteremia seen in three different settings (private office, emergency department, their own child) to see if any differ...

BACKGROUND A challenge in the empiric treatment of complicated urinary tract infection (cUTI) is identifying the initial appropriate antibiotic therapy (IAAT), which is associated with reduced length of stay and mortality compared with initial inappropriate antibiotic therapy (IIAT). We evaluated the cost-effectiveness of ceftolozane/tazobactam compared with piperacillin/tazobactam (one of the ...

BACKGROUND Although frameless stereotactic needle biopsy is an accepted procedure for the diagnosis of intracranial lesions, findings are nondiagnostic in 2-15% of patients and no recommendations yet exist to guide subsequent care. After reviewing the postoperative course after nondiagnostic biopsy of 28 patients, we developed a paradigm to guide management in the future. METHODS In reviewing...

Initial antimicrobial treatment of patients with deep seated or invasive infections is typically empiric. Usually, cultures of specimens obtained from the suspected source of infection are performed to identify pathogens and guide continued antimicrobial treatment. When patients present with signs and symptoms of infection, but sterile body fluid or tissue specimens cannot be obtained in a time...

STUDY OBJECTIVE To assess the effectiveness, safety, and cost of empiric treatment of febrile neutropenia before and after implementing an algorithm in which voriconazole was substituted for liposomal amphotericin B (L-AmB). DESIGN Retrospective cohort analysis. SETTING An 850-bed tertiary care hospital, which is also a referral site for patients with acute leukemia. PATIENTS Fifty-five a...

INTRODUCTION Pneumonia impacts over four million people annually and is the leading cause of infectious disease-related hospitalization and mortality in the United States. Appropriate empiric antimicrobial therapy decreases hospital length of stay and improves mortality. The objective of our study was to test the hypothesis that the presence of an emergency medicine (EM) clinical pharmacist imp...

BACKGROUND Herpes simplex encephalitis is associated with substantial morbidity and mortality and may be related to timely diagnosis and treatment. While awaiting the results of testing, hospitalization and empiric treatment with acyclovir is recommended, though the direct and indirect costs associated with this management are substantial. We sought to examine children hospitalized for possible...

the empiric antibiotic therapy can result in antibiotic overuse, development of bacterial resistance and increasing costs in critically ill patients. the aim of the present study was to evaluate the effect of procalcitonin (pct) guide treatment on antibiotic use and clinical outcomes of patients admitted to intensive care unit (icu) with systemic inflammatory response syndrome (sirs).  a total ...

It is well known that corticosteroids improve asthma in a subgroup of patients and that this responder subgroup is invariably large enough to drive statistically significant differences in asthma outcomes when steroids are compared to placebo in unselected patients. The consistency of clinical trial data showing benefit from corticosteroids, especially in less severe patients, is the reason why...